| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,134 |
3,050 |
$163K |
| V2020 |
Frames, purchases |
3,329 |
3,142 |
$55K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,526 |
1,398 |
$45K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,206 |
2,055 |
$43K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
346 |
333 |
$17K |
| 92133 |
|
490 |
469 |
$14K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
562 |
531 |
$10K |
| 92250 |
|
192 |
183 |
$10K |
| 95930 |
|
210 |
195 |
$9K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
57 |
56 |
$3K |
| 92025 |
|
64 |
63 |
$2K |
| 92083 |
|
22 |
19 |
$883.98 |
| 92082 |
|
20 |
20 |
$670.89 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
748 |
738 |
$663.00 |
| 92285 |
|
47 |
42 |
$642.69 |
| 92015 |
Determination of refractive state |
92 |
78 |
$580.62 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$187.00 |